Tibolt, Robert Earl
Tibolt, Robert Earl is an sole proprietor health care provider with primary practice located at 655 Medical Center Dr Ne , Salem OR 97301-2751. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Tibolt, Robert Earl can be contacted via phone (503) 581-5287.Contact Information
Primary practice address
655 Medical Center Dr Ne
Salem OR 97301-2751
Phone: (503) 581-5287
Fax: (503) 588-6843
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD16218 | Oregon |
Profile Details
| NPI number | 1467456061 |
|---|---|
| LBN Legal business name | Tibolt, Robert Earl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Nov 1st, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467456061 | NPPES |
| Oregon | MEDICAID | 043369 |
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